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Organization
SJ ORAL SURGERY PC
Active
Organization
SJ ORAL SURGERY PC
Active
Other names
South Jordan Oral and Facial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DAYNE JENSEN MD, DMD (PRESIDENT)
(801) 698-7121
Entity
Organization
Contact information
Practice address
3632 W SOUTH JORDAN PKWY STE 103, SOUTH JORDAN, UT 84009-7163
(580) 355-6000
Mailing address
3632 W SOUTH JORDAN PKWY STE 103, SOUTH JORDAN, UT 84009-7163
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
183
OK
Other
Enumeration date
03/27/2018
Last updated
03/27/2018
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